Abstract
Purpose of Review
In this review, we examine the current literature regarding the use of cranberry and other complimentary methods for the prevention of catheter-associated urinary tract infections (CAUTIs).
Recent Findings
Some studies have suggested cranberry products may have a positive effect in reducing the incidence of CAUTIs in patients with normal bladder function receiving short-term catheterization, while other studies have failed to show the benefits of cranberry products for the reduction of CAUTIs.
Summary
While there is some data suggesting cranberry-derived products may reduce CAUTIs in specific patient populations, there is currently overall insufficient clinical data to recommend broad usage of cranberry products for the reduction of CAUTIs. Many of the studies reviewed have significant limitations in size, design, and lack standardization.
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References
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ACH Surveillance for UTI (CAUTI). Centers for Disease Control and Prevention. Centers for Disease Control and Prevention; 2020 [cited 2020Apr28]. Available from: https://www.cdc.gov/nhsn/acute-care-hospital/cauti/index.html.
Tambyah PA, Maki DG. Catheter-associated urinary tract infection is rarely symptomatic. Arch Intern Med. 2000;160(5). https://doi.org/10.1001/archinte.160.5.678.
Saint S. Clinical and economic consequences of nosocomial catheter-related bacteriuria. Am J Infect Control. 2000;28(1):68–75. https://doi.org/10.1016/s0196-6553(00)90015-4.
Healthcare-associated infections in acute care hospitals. 2018 [cited 2020Aug28]. Available from: https://www.ecdc.europa.eu/en/healthcare-associated-infections-acute-care-hospitals.
Estimating the additional hospital inpatient cost and mortality associated with selected hospital-acquired conditions. AHRQ. [cited 2020Apr28]. Available from: http://www.ahrq.gov/hai/pfp/haccost2017-results.html.
Gupta K, Chou M, Howell A, Wobbe C, Grady R, Stapleton A. Cranberry products inhibit adherence of p-fimbriated Escherichia coli to primary cultured bladder and vaginal epithelial cells. J Urol. 2007;177(6):2357–60. https://doi.org/10.1016/j.juro.2007.01.114.
Howell AB, Botto H, Combescure C, Blanc-Potard A-B, Gausa L, Matsumoto T, et al. Dosage effect on uropathogenic Escherichia coli anti-adhesion activity in urine following consumption of cranberry powder standardized for proanthocyanidin content: a multicentric randomized double blind study. BMC Infect Dis. 2010;10(1). https://doi.org/10.1186/1471-2334-10-94.
Ohnishi R, Ito H, Kasajima N, Kaneda M, Kariyama R, Kumon H, et al. Urinary excretion of anthocyanins in humans after cranberry juice ingestion. Biosci Biotechnol Biochem. 2006;70(7):1681–7. https://doi.org/10.1271/bbb.60023.
Cooper KL, Badalato GM, Rutman MP. Infections of the urinary tract. In: Partin AW, Peters CA, Kavoussi LR, Dmochowski RR, Wein AJ, editors. Campbell-Walsh urology. Philadelphia: Elsevier; 2020.
• Luís Â, Domingues F, Pereira L. Can cranberries contribute to reduce the incidence of urinary tract infections? A systematic review with meta-analysis and trial sequential analysis of clinical trials. J Urol. 2017;198(3):614–21. https://doi.org/10.1016/j.juro.2017.03.078A systematic review of clinical trials of cranberry for the prevention of UTIs, demonstrating a positive effect for cranberry.
Wang C-H, Fang C-C, Chen N-C, Liu SS-H, Yu P-H, Wu T-Y, et al. Cranberry-containing products for prevention of urinary tract infections in susceptible populations. Arch Intern Med. 2012;172(13). https://doi.org/10.1001/archinternmed.2012.3004.
Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2012. https://doi.org/10.1002/14651858.cd001321.pub5.
Jepson R, Craig J, Williams G. Cranberry products and prevention of urinary tract infections. JAMA. 2013;310(13):1395. https://doi.org/10.1001/jama.2013.277509.
Anger J, Lee U, Ackerman AL, Chou R, Chughtai B, Clemens JQ, et al. Recurrent uncomplicated urinary tract infections in women: AUA/CUA/SUFU Guideline. J Urol. 2019;202(2):282–9. https://doi.org/10.1097/JU.0000000000000296.
Foxman B, Cronenwett AEW, Spino C, Berger MB, Morgan DM. Cranberry juice capsules and urinary tract infection after surgery. Obstet Gynecol Surv. 2015;70(12):749–50. https://doi.org/10.1097/ogx.0000000000000267.
• Gunnarsson AK, Gunningberg L, Larsson S, Jonsson KB. Cranberry juice concentrate does not significantly decrease the incidence of acquired bacteriuria in female hip fracture patients receiving urine catheter: a double-blind randomized trial. Clin Interv Aging. 2017;12:137–43. https://doi.org/10.2147/cia.s113597A randomized study of cranberry capsules for the prevention of CAUTIs in short-term catheterized patients who had undergone repair of hip fractures did not demonstrate a benefit. However, study was significantly underpowered compared to initial design.
• Shatkin-Margolis A, Warehime J, Pauls RN. Cranberry supplementation does not reduce urinary tract infections in patients with indwelling catheters after pelvic reconstructive surgery. Female Pelvic Med Reconstruct Surg. 2018;24(2):130–4. https://doi.org/10.1097/spv.0000000000000507A retrospective study of cranberry capsules for the prevention of CAUTIs in short-term catheterized female patients who underwent pelvic reconstructive study did not show a reduction in UTIs.
Biggel M, Heytens S, Latour K, Bruyndonckx R, Goossens H, Moons P. Asymptomatic bacteriuria in older adults: the most fragile women are prone to long-term colonization. BMC Geriatrics. 2019;19(1). https://doi.org/10.1186/s12877-019-1181-4.
• Thomas D, Rutman M, Cooper K, Abrams A, Finkelstein J, Chughtai B. Does cranberry have a role in catheter-associated urinary tract infections? Can Urol Assoc J. 2017;11(11). https://doi.org/10.5489/cuaj.4472A small prospective study suggesting a positive benefit of cranberry capsule with a standardized dose of PAC could be effective in reducing CAUTIs in patients with chronic indwelling catheters.
• Sappal S, Goetz LL, Vince R, Klausner AP. Randomized trial of concentrated proanthocyanidins (PAC) for acute reduction of bacteriuria in male veterans with spinal cord injury utilizing clean intermittent catheterization. Spinal Cord Ser Cases. 2018;4(1). https://doi.org/10.1038/s41394-018-0087-2A small prospective study of cranberry in SCI patients did not demonstrate a benefit fit in subjective urine quality or reduction in colony count.
Hess MJ, Hess PE, Sullivan MR, Nee M, Yalla SV. Evaluation of cranberry tablets for the prevention of urinary tract infections in spinal cord injured patients with neurogenic bladder. Spinal Cord. 2008;46(9):622–6. https://doi.org/10.1038/sc.2008.25.
Lee BB, Haran MJ, Hunt LM, Simpson JM, Marial O, Rutkowski SB, et al. Spinal-injured neuropathic bladder antisepsis (SINBA) trial. Spinal Cord. 2006;45(8):542–50. https://doi.org/10.1038/sj.sc.3101974.
Lo TS, Hammer KD, Zegarra M, Cho WC. Methenamine: a forgotten drug for preventing recurrent urinary tract infection in a multidrug resistance era. Expert Rev Anti-Infect Ther. 2014;12(5):549–54. https://doi.org/10.1586/14787210.2014.904202.
Vainrub B, Musher DM. Lack of effect of methenamine in suppression of, or prophylaxis against, chronic urinary infection. Antimicrob Agents Chemother. 1977;12(5):625–9. https://doi.org/10.1128/aac.12.5.625.
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Ji, L., Badalato, G.M., Chung, D.E. et al. Cranberry Products for the Prevention of Catheter-Associated Urinary Tract Infections. Curr Bladder Dysfunct Rep 15, 303–307 (2020). https://doi.org/10.1007/s11884-020-00610-3
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DOI: https://doi.org/10.1007/s11884-020-00610-3